Regional Disparities and Socioeconomic Determinants of Cancer Survival in Saudi Arabia: A Comprehensive Population-based Analysis of 26,487 Patients from 2010 to 2024

Abstract Background: Cancer is the fifth-leading cause of mortality in Saudi Arabia, with 28,000 new cases and 13,400 annual fatalities. The Saudi government has invested considerably in health care, but there is little study on how location and income affect cancer survival rates. This study examines regional cancer survival rates, socioeconomic status and survival trends from 2010 to 2024. Methods: we reviewed data from 26,487 Saudi people diagnosed with cancer from 2010 to 2024. We used multi-state modelling, Cox regression and Kaplan–Meier analysis to investigate survival patterns in hospital records from all 13 Saudi Arabian areas and the National Cancer Registry, accounting for competing hazards. Results: Five-year survival rates varied by location (45.2%–68.7%; adjusted hazard ratio [HR] highest versus. lowest region: 0.68, 95% confidence interval [CI] 0.62–0.74). High socioeconomic position and specialised centre access independently predicted improved survival (adjusted HR highest vs. lowest education: 0.65, 95% CI 0.58%E2%80%930.72). Early-stage cancer survival has increased dramatically. Some advanced-stage cancer facilities have improved, but others have not. Access to advanced cancer centres is crucial since they have greater survival rates. Overall, the survival rate has increased from 53.3% in 2010–2014 to 58.6% in 2020–2024. Conclusion: Although cancer treatment has improved, not everyone has profited equally. Living conditions and socioeconomic level still affect survival rates. Saudi Arabia’s Vision 2030 targets, which include enhancing early cancer identification in underserved areas and making specialised treatment more accessible, require substantial work. To provide everyone with a greater chance of health and survival, close the care gap.